I have a lot of experience with premies who are now at home, often sent home
still very small. Some still under 4 pounds. They need to gain weight and
grow.  I am aware of the research on the work of bottle feeding vs
breastfeeding. However, many of these little ones can not transfer enough
milk at the breast  for adequate growth. This puts them at considerable risk
for insufficient caloric intake. Many of these mothers are pumping and
providing all breastmilk feeds by bottle. Given a little time and growth,
most of these babies transition to the breast very well.Sometimes, I think
preterms are beter at this transition than the full terms who are having
problems breastfeeding. Each breastfeeding dyad needs to be evaluated
individually. Use of upright, paced bottle feeds, in my clinical experience,
can be a more effective feeding method than long, slow, arduous breastfeeds
for the early baby now at home. I prefer not to call this the bottle vs
breast discussion, but the bottle leading to the breast discussion. Ann
Anderson, RN,IBCLC NJ
>   >> 

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